How can a standardised health insurance product benefit stakeholders in India?

Private health insurance in India has seen continuous growth since private players entered the market in 2001 and standalone health insurance companies started entering the market in 2007. Even though several new products and services have been added by the private players, such as top-ups, disease-specific programmes, wellness-focused strategies, critical illness coverage and hospital cash among others, the market is still dominated by variants of Mediclaim, which public sector companies started to offer before privatisation of the insurance sector.

While all Mediclaim products have similar benefit designs, there are some differences, including but not limited to:

  • Waiting period for pre-existing diseases
  • List of exclusions
  • Sub-limits for services such as room rent or ICU
  • Condition-specific sub-limits
  • Inclusion of maternity benefit
  • Member co-payments
  • Size of hospital network
  • Premiums charged for similar coverage

In this article, initially published in Asia Insurance Review, Milliman’s Rachin Aggarwal and Abhishek Agrawal examine how a standard health product would benefit various stakeholders, including consumers, insurers, providers and regulators and policy makers.

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